Official Report 838KB pdf
The next item of business is topical question time.
Children’s Eyesight (Lockdown Impacts)
To ask the Scottish Government what its response is to reports that the Covid-19 lockdowns might have left a generation of children in Scotland with damaged eyesight. (S6T-02322)
The Covid-19 pandemic was the greatest shock to our health and social care system since the establishment of the national health service. The lockdowns were a necessary public health measure to protect life. There is evidence that there is a global rise in shortsightedness, otherwise known as myopia. That is caused by a range of factors, including more screen-based activities. However, it would not be appropriate for me to speculate on precise causes, although it is possible that the pandemic has exacerbated those.
The analysis that was carried out by Ninewells hospital and the University of London, following a study that compared results from eight Scottish health board areas for three years before the pandemic with results after the pandemic, should be deeply concerning to us all, because it found that there has been a 42 per cent increase in shortsightedness, or myopia, in the wake of the pandemic lockdowns.
Given that it is so unusual for conditions such as myopia to set in at such a young age, those results are concerning. The Scottish Government’s see4school campaign is very successful in picking up vision issues in preschoolers, but what information does the Scottish Government currently have on sight and vision standards for primary and secondary pupils?
I agree that the findings are concerning. Of course, we wish to do everything that we possibly can to prevent myopia from occurring and, where it has occurred in the population, to address that through the availability of optometry services and the expansion of those services in the community. All children aged under 16, and those who are aged between 16 and 18 and in full-time education, are entitled to NHS-funded help with the cost of glasses and contact lenses.
I encourage any parent—I declare an interest, as a father of four—who has concerns about their child’s vision to arrange a free NHS eye examination with an optometry practice, and I strongly encourage children to undertake as much outdoor play as possible, as those areas have been assessed as assisting in preventing myopia from happening in the first place and in its rehabilitation.
Again, I thank the cabinet secretary for his response and for the tone that he has taken on the matter so far today.
The study that I mentioned is wide ranging and has found a clear link between shortsightedness and living in urban areas with a large number of flats. For example, children who are living in the Greater Glasgow and Clyde and Lothian health board areas have been found to be twice as likely to be myopic as those in the Highlands and in Ayrshire and Arran. International studies, such as those conducted in China, where lockdowns were particularly strict, also show a sharp increase in myopia among seven and eight-year-olds.
With all those worrying trends, there is now a louder call for a sustained and repeated testing programme to be rolled out for slightly older year groups, including seven and eight-year-olds. Does the Scottish Government agree that an extended testing programme should be considered? Will the cabinet secretary report back to Parliament with the results of any in-depth studies regarding that public health issue?
Vision is one of eight developmental domains that are assessed by a health visitor during universal child health reviews at 13 to 15 months, 27 to 30 months and four to five years. Health visitors can provide appropriate intervention in response to any concerns at those stages.
In addition, in 2023, we launched our early child development transformational change programme, which supports the provision of oversight and better integration of policies that contribute to early child development, with a focus on prevention to emphasise the importance of pre-birth and early years. Nevertheless, I absolutely take the point that Roz McCall makes regarding the evidence that she points to from elsewhere, and we will continue to consider that.
I am grateful that, as the cabinet secretary said, the Scottish Government has committed to ensuring that everyone in Scotland—and children and young people, in particular—is entitled to receive free NHS eye tests to make sure that preventative care is offered to those who need it before their eyesight worsens.
Can the cabinet secretary advise us on how the Government will build on Scotland’s world-leading eyecare service in the future?
The Government is committed to delivering new, enhanced services that utilise the capacity of community optometrists to manage more patients closer to home, reducing the burden on hospitals and general practitioners. We have made provision for that in the budget that we have set out for next year, which will be debated this afternoon.
We are already rolling out a new community glaucoma service, which provides capacity for lower-risk glaucoma patients to be discharged from hospital and registered instead with accredited community optometrists. We will also expand our free universal NHS eye examination service in 2025 to support independent prescribing community optometrists to manage patients who have more complex acute anterior eye conditions, who are currently normally referred to hospital.
The cabinet secretary is aware of the see4school programme, which gives an orthoptic vision test for preschoolers between the ages of four and five—indeed, he has just made reference to it. There is also the very successful national dental inspection programme that operates between primary 1 and primary 7. Those programmes highlight potential challenges that young children face and act as an interface with the school to assist with children’s health as well as their education. Would the cabinet secretary be willing to meet members from all parties to discuss the ophthalmic research and the dental research to see how there can be better linkages between the health and the education needs of children?
In the interests of brevity, I will simply say that Martin Whitfield points to a range of successful interventions that have made a real difference in children’s lives and in their ability to interact at school. The Minister for Public Health and Women’s Health, education colleagues or I would be more than happy to have that discussion on a cross-party basis.
Access to Banking Services (Branch Closures)
To ask the Scottish Government what discussions it has had with the banking sector regarding how to ensure that communities do not lose access to banking services, in light of reports that Lloyds Banking Group plans to close 14 Bank of Scotland branches over the next two years. (S6T-02335)
Ministers were concerned to hear Lloyds Banking Group’s decision to close 14 Bank of Scotland branches across Scotland. Any reduction in branches raises concerns not only for the affected employees but for access to services, particularly for rural communities, vulnerable individuals and digitally excluded customers.
The Scottish Government regularly engages with the banking sector, including the regulator, through ministerial meetings and the financial services growth and development board. We will raise the issue with Lloyds Banking Group at the next meeting.
In October 2024, I convened a cross-party round-table event on access to cash and banking services in Scotland. Lloyds Banking Group attended alongside other banks and sector representatives including the Financial Conduct Authority, LINK, Cash Access UK and the Post Office. That provided a common understanding of Scotland-specific challenges and a basis for consistent engagement as the new regulatory regime embeds.
With the closures, communities across Scotland, including Wester Hailes in Edinburgh, will lose access to vital financial services. That will particularly affect older and vulnerable people who cannot access online services. Does the minister agree that in-person banking is an important public service, not just a business decision? What recent discussion has the Scottish Government had with the Financial Conduct Authority on the issue?
The member is quite correct to raise those concerns, which are shared by the Scottish Government and by all parties in the chamber. Financial regulation is reserved to the United Kingdom Government. The FCA, which is the regulator, introduced access to cash rules recently in response to concerns that were expressed by communities the length and breadth of the UK, particularly in rural Scotland and some Scottish communities. That is why it is important that Lloyds Banking Group engages with LINK and the regulator with regard to its announcement, and I understand that it has done that. Of course, alternative arrangements will be put in place for a number of the announced closures, although that will not address all the concerns that will be expressed by communities. That is why financial exclusion continues to be a concern for us all.
I have previously been contacted by constituents regarding bank closures in Bathgate, where a banking hub is now planned to open. However, although more than 600 bank branches have closed since 2015, there are only 21 banking hubs in Scotland. How is the Scottish Government working to identify areas that are most in need of banking hubs, and what representations are being made to speed up their roll-out?
The job of identifying such areas falls to LINK under the new access-to-cash rules that have been adopted by the regulator, the FCA. I recommend that any member who has concerns that those issues have not been adequately addressed since the bank announced its decision to close those branches should urgently contact LINK to ensure that there is a reassessment of the needs locally.
My West Scotland region is not immune to Bank of Scotland branch closures. Closures are expected in Bishopbriggs, Kirkintilloch, Alexandria and Helensburgh. In Helensburgh, that will represent the closure of the last in-person bank branch. That will be devastating for many of my constituents, especially the older constituents who are unable to use online banking. What is the Scottish Government doing to fight digital exclusion and to ensure that people have access to the banking services that they require locally?
I very much identify with the member’s concerns, not least because my constituency was one of the hardest hit—if not the hardest hit—in the whole of Scotland by bank closures in recent years.
On what the Scottish Government has done, we spoke to the regulator at a round-table meeting. We were keen for access-to-cash rules to be updated to be made stronger, and new rules on that were introduced a few months ago by the regulator.
A banking hub will be introduced in Helensburgh, for example. That might not go all the way to satisfy the concerns—I absolutely understand that—but regulation of the banks is a reserved matter. I know that the banking hub in Forres, in my constituency, has been popular.
Those measures have resulted from on-going dialogue between the Scottish Government and others, including the UK regulator, LINK and others who have a say in the matter. I urge the member to contact LINK if she has further concerns that those measures do not go far enough.
In addition to the communities that Pam Gosal mentioned, in places including Barrhead and Bishopbriggs in my region, the Bank of Scotland has the last remaining branch on the high street and so is the last bank in the town. Does the minister recognise the particular pressure and disadvantage that is put on local communities by there being no banks left in their areas? Although I understand that the Scottish Government cannot compel banks to keep branches open, will he impress on the Bank of Scotland, in his discussions with it, the importance of access to cash in those communities?
I will certainly ensure that that happens. I share the member’s concern that, as technology moves apace and people turn to digital banking in greater numbers, there is a danger that other people are left behind. That is why the Scottish Government is also funding a number of digital inclusion projects through the voluntary sector. That is an important part of this.
I understand that a banking hub is to be introduced in Bishopbriggs and I will absolutely ensure that the member’s wider concerns are conveyed to the bank.
Ambulance Crews (Mental Health Absences)
I refer members to my entry in the register of members’ interests. I am a member of Unison.
To ask the Scottish Government what its response is to reports that mental health absences among ambulance crews have risen in Aberdeen and other parts of Scotland. (S6T-02326)
I take this opportunity to put on record my thanks to all national health service and social care staff for their incredible service.
In this case, we are discussing issues that paramedics are facing, which I absolutely recognise from the meetings that the First Minister and I held over Christmas, as well as from the visit that I paid to the Scottish Ambulance Service in Edinburgh before Christmas.
Healthcare services are under significant pressure, and we must ensure that support is sustainable and aligned with staff needs. We will continue collaborating with healthcare leaders and staff to identify and address areas of stress and take actions to provide support. Staff wellbeing is absolutely paramount. From 2024-25, the Scottish Government is dedicating more than £2.5 million annually to support staff wellbeing. Since 2019, the Scottish Government has invested more than £480,000 in the development and implementation of the national Lifelines Scotland programme.
Ambulance stacking at Aberdeen royal infirmary has caused a great deal of stress for ambulance crews, according to a paramedic who I listened to yesterday. That, of course, has consequences.
What is being done to improve patient flow at ARI to improve the situation? Has best practice from elsewhere been brought into play in Aberdeen?
I absolutely recognise the scenario that Kevin Stewart outlines and the impact that ambulance stacking has on staff across the system, but in particular on paramedics. Officials have been meeting the executive team at NHS Grampian to discuss actions that can be taken to ease pressures. The central aim is to improve patient flow through the system, from the Scottish Ambulance Service into NHS Grampian’s acute sites and back into the community as soon as patients are fit for discharge. The Scottish Ambulance Service and Grampian’s health and social care partnerships have been collaborating to implement their unscheduled care improvement plan. The centre for sustainable delivery is also providing support to NHS Grampian; it has identified opportunities within its acute system for more efficient use of in-patient capacity and learning from best practice elsewhere.
People who I have talked to in the past few days have been highly complimentary of our paramedics and the job that they do. What more can the Government do to ease the strain on and improve the wellbeing of ambulance crews? What measures in the Scottish budget will help in that regard?
I absolutely echo the compliments for our Scottish Ambulance Service staff, as I set out in my answer to Kevin Stewart’s first question.
If the 2025-26 Scottish budget, which we will hear about shortly, is agreed by the Scottish Parliament, it will provide record funding of £21 billion to health and social care. That includes an increase for the Scottish Ambulance Service of more than £88 million, taking its baseline funding to £437.2 million for 2025-26. That will help the service to continue to develop, enhance capacity and deliver high-quality patient care across Scotland.
Further, our wellbeing services include a 24/7 compassionate listening service through the national wellbeing helpline; self-guided resources via the national wellbeing hub; confidential mental health care through the workforce specialist service; and access to psychological therapies.
In Ayrshire and Arran, ambulances have had to wait more than five hours before patients can be admitted, due to lack of capacity. Insufficient workforce planning has meant that NHS services have been unable to cope with high pressures and demand. That clearly links to the mental health pressures that have been placed on ambulance crews. Despite that, newly qualified paramedics are being forced to relocate, due to a shortage of job opportunities in Scotland. Surely the Government recognises that better workforce planning would alleviate some of the pressure that is felt by the Scottish Ambulance Service. What steps is the cabinet secretary taking to ensure that Scotland fully benefits from the investment that has been made in paramedic education and training?
Carol Mochan will recognise that we have increased investment in the Scottish Ambulance Service, which has resulted in an increased number of paramedics being employed by the service. As I said in answer to Kevin Stewart, the provisions that we are setting out in the budget will allow the Scottish Ambulance Service to continue that investment and maintain capacity.
I would be more than happy to engage further with the member on the points that she has raised on training.
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Budget (Scotland) (No 4) Bill: Stage 1